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Ask the Experts about Facial Wasting
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Combivir and wasting?
Feb 19, 2009

Good day, I have been on Combivir approximately 7 months and see some evidence of facial wasting. It is mostly in my cheeks and my eyes have a more "sunken" appearance of late. Is this due to my meds or just a side effect of HIV in general? The look bothers me and I want to find out if anything can be done, perhaps changing meds, however I have only been HIV+ for 2 years. At this early stage is it normal for this type of wasting to occur? Thank you for any help.

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   Response from Dr. Pierone

Hello, and thanks for posting.

Combivir is one of the medications linked to development of lipoatrophy, largely because it contains AZT. AZT (zidovudine, Retrovir) clearly increases the risk of lipoatrophy. Studies have shown that switching off AZT (sooner rather than later) will lead to improvements in facial thinning. Lipoatrophy generally comes on gradually after years of exposure to antiretroviral medications, but some people develop it sooner.

The best strategy would be to change from AZT to tenofovir (Viread). Multiple trials have documented the effectiveness of this change in preventing worsening of lipoatrophy.

Good luck!


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